Staff Utilization Management Pharmacist (Contract)
About the position
The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a vital role within our organization, dedicated to ensuring that health comes first for our community. This position involves conducting medical necessity and comprehensive medication reviews for prescriptions that require pre-authorization. The work assignments for this role are diverse and often necessitate the interpretation of complex information and independent decision-making regarding the appropriate courses of action. The Clinical Pharmacist will perform thorough reviews that encompass a complete analysis of the medication care plan, an investigation into overall utilization, and the identification of any unusual usage patterns. This role is crucial in intervening and advising both patients and providers to promote cost-effective utilization and enhance quality patient outcomes as needed. In addition to the clinical responsibilities, the Utilization Management Clinical Pharmacist 2 must possess a strong understanding of departmental, segment, and organizational strategies and operating objectives, including their interconnections with related areas. The pharmacist will be expected to make informed decisions regarding their work methods, even in ambiguous situations, and will require minimal direction while receiving guidance when necessary. Adherence to established guidelines and procedures is essential in this role, as is the ability to leverage oneΒs skills to make a significant impact on patient care and organizational efficiency.
Responsibilities
Β Complete medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
,
Β Conduct a full analysis of the medication care plan and investigate overall utilization.
,
Β Identify unusual usage patterns and intervene as necessary to promote cost-effective utilization.
,
Β Advise patients and providers to enhance quality patient outcomes.
,
Β Understand and align with department, segment, and organizational strategies and objectives.
,
Β Make independent decisions regarding work methods in ambiguous situations with minimal direction.
Requirements
Β Bachelor's degree or Pharm.D from an accredited college of pharmacy.
,
Β Active license with the Board of Pharmacy in the state of residence.
,
Β Ability to participate in Federal prescription programs (Medicare/Medicaid reviews).
,
Β Self-directed with the ability to work well in a group setting.
,
Β Strong problem-solving skills and ability to encourage collaborative problem solving.
,
Β Focused, accurate, and highly productive work ethic.
,
Β Strong communication skills.
,
Β Proficient with various computer systems.
Nice-to-haves
Β Managed care experience, specifically in Utilization Management review.
Benefits
Β Paid time off
,
Β 401(k) retirement savings plan
,
Β Employee assistance program
,
Β Business travel and accident insurance
Apply Now
The Utilization Management Clinical Pharmacist 2 (VSP/PT) is a vital role within our organization, dedicated to ensuring that health comes first for our community. This position involves conducting medical necessity and comprehensive medication reviews for prescriptions that require pre-authorization. The work assignments for this role are diverse and often necessitate the interpretation of complex information and independent decision-making regarding the appropriate courses of action. The Clinical Pharmacist will perform thorough reviews that encompass a complete analysis of the medication care plan, an investigation into overall utilization, and the identification of any unusual usage patterns. This role is crucial in intervening and advising both patients and providers to promote cost-effective utilization and enhance quality patient outcomes as needed. In addition to the clinical responsibilities, the Utilization Management Clinical Pharmacist 2 must possess a strong understanding of departmental, segment, and organizational strategies and operating objectives, including their interconnections with related areas. The pharmacist will be expected to make informed decisions regarding their work methods, even in ambiguous situations, and will require minimal direction while receiving guidance when necessary. Adherence to established guidelines and procedures is essential in this role, as is the ability to leverage oneΒs skills to make a significant impact on patient care and organizational efficiency.
Responsibilities
Β Complete medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization.
,
Β Conduct a full analysis of the medication care plan and investigate overall utilization.
,
Β Identify unusual usage patterns and intervene as necessary to promote cost-effective utilization.
,
Β Advise patients and providers to enhance quality patient outcomes.
,
Β Understand and align with department, segment, and organizational strategies and objectives.
,
Β Make independent decisions regarding work methods in ambiguous situations with minimal direction.
Requirements
Β Bachelor's degree or Pharm.D from an accredited college of pharmacy.
,
Β Active license with the Board of Pharmacy in the state of residence.
,
Β Ability to participate in Federal prescription programs (Medicare/Medicaid reviews).
,
Β Self-directed with the ability to work well in a group setting.
,
Β Strong problem-solving skills and ability to encourage collaborative problem solving.
,
Β Focused, accurate, and highly productive work ethic.
,
Β Strong communication skills.
,
Β Proficient with various computer systems.
Nice-to-haves
Β Managed care experience, specifically in Utilization Management review.
Benefits
Β Paid time off
,
Β 401(k) retirement savings plan
,
Β Employee assistance program
,
Β Business travel and accident insurance
Apply Now